Orthopedic Surgery Resident HCA Healthcare/USF Morsani College of Medicine GME: HCA Florida Largo Hospital, Department of Orthopedic Surgery
Disclosure(s):
Nathan Elder, D.O.: No financial relationships to disclose
Introduction: Single position prone trans-psoas (PTP) lateral lumbar interbody fusion (LLIF) has traditionally been an inpatient procedure. Given the minimally invasive and single position advantage, this procedure lends itself to transition to the same-day outpatient setting. There is a paucity of literature reporting the safety profile and feasibility when performed as a same-day procedure. This study aims to examine the acute safety of performing outpatient PTP LLIF, in comparison to previously analyzed cohorts in existing literature.
Methods: Prospectively collected data from 2021 to 2024 was retrospectively reviewed from a single same-day surgery center. All patients 18 years or older undergoing same-day PTP-LLIF by single surgeon were reviewed. Patient demographics, intra- and perioperative data were collected on all cases.
Results: Thirteen patients underwent same-day PTP-LLIF procedure with five being revision procedures. Mean age was 53 years (range 22-63), mean body mass index (BMI) was 29.2 (24-36), and average American Society of Anesthesiologists (ASA) class was 2. There were three current smokers, five nonsmokers, and five former smokers. The mean operative time was 118 minutes (85-157 mins), mean operating room time was 191 minutes (158-227 mins), and mean recovery time was 142 minutes (87-228 mins). Operative levels included L2-3 (3), L3-4 (9), and L4-5 (1). Three of the L3-4 cases were multi-level fusions coupled with a L4-5 TLIF. No acute returns to the OR, emergency room visits or unplanned office visits occurred.
Conclusion : This study aims to examine the acute safety of performing outpatient PTP LLIF, in comparison to existing literature. Similar to Chin et al who reported no adverse events with LLIF performed in the lateral position at a same-day surgery center, there were no adverse events in our cohort. Given the small cohort of patients there continues to be opportunity for further study and transitioning to same-day discharge to home.